Infographic: The Availability and Use of Medication Abortion Care - PowerPoint Presentation

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Infographic: The Availability and Use of Medication Abortion Care

October 2021

The Availability and Use of Medication Abortion Care

In 2018, medication abortion accounted for 54% of abortions before 9 weeks gestation in the U.S.

SOURCE:

Kortsmit

K,

Jatlaoui

TC, Mandel MG, et al.

Abortion Surveillance — United States, 2018

. MMWR

Surveill

Summ

2020;69(No. SS-7):1–29.

SOURCE: Ireland LD, Gatter

M, Chen AY. Medical Compared With Surgical Abortion for Effective Pregnancy Termination in the First Trimester. Obstet Gynecol. 2015 Jul;126(1):22-8.

Raymond EG, Shannon C, Weaver MA, Winikoff B. First-trimester medical abortion with mifepristone 200 mg and misoprostol: a systematic review. Contraception. 2013 Jan;87(1):26-37. doi: 10.1016/j.contraception.2012.06.011.

Medication Abortion Care is a Safe and Effective Option to End an Early Pregnancy

SOURCE: U.S. Food and Drug Administration, Mifeprex (mifepristone) Information, current as of 4/13/2021.

The FDA is Reviewing the Risk Evaluation and Mitigation Strategy (REMS) in Place for Mifepristone

REMS Requirements:

The prescribing clinician must be certified by a mifepristone distributor.

The prescriber may only dispense to patients in-person in health care settings.

 FDA enforcement suspended during the COVID-19 emergency

The prescriber must obtain a patient agreement form from the patient before dispensing mifepristone.

The REMS limits distribution of mifepristone to certified providers and bans retail pharmacies and all other providers from dispensing the medication.

SOURCE: KFF Analysis of State Laws, October 2021; KFF Private Communications with the American Association of Nurse Practitioners (AANP), 2020; Guttmacher Institute, Medication Abortion, October 2021; 

Advancing New Standards in Reproductive Health (ANSIRH), the National Abortion Federation (NAF) and RhN, Providing Abortion Care: A Professional Toolkit for Nurse-Midwives, Nurse Practitioners, and Physician Assistants, 2018. 

18 States and DC Allow Both Advance Practice Clinicians (APCs) and MDs to Dispense Abortion Pills

APCs also permitted to dispense (18 states and DC)

Only MDs permitted to dispense (32 states)

Studies have documented that mifepristone can be safety dispensed by both APCs (

e.g

nurse practitioners, physician associates, and nurse midwives) and MDs.

SOURCE: Meurice, M., Whitehouse, K., Blaylock, R., Chang, J., Lohr, P. Client satisfaction and experience of telemedicine and home use of mifepristone and misoprostol for abortion up to 10 weeks’ gestation at British Pregnancy Advisory Service: A cross-sectional evaluation. Contraception. 2021 May;104(1): 61-66.

Upadhyay UD, Koenig LR, Meckstroth KR. Safety and Efficacy of Telehealth Medication Abortions in the US During the COVID-19 Pandemic.

JAMA Netw Open.

2021;4(8). Raymond, E., Chong, E.,

Winikoff, B., Bednarek, P., Keady, M. &

Priegue, E. TelAbortion: evaluation of a direct to patient telemedicine abortion service in the United States. Contraception. 2019 September; 100(3):173-177.

Telehealth for Medication Abortion Has Been Available on a Trial Basis for Years, and More Broadly During the Pandemic

Research shows that medication abortion via telehealth is as safe and effective as in-person dispensing.

Some telehealth companies offer virtual doctor’s appointments and mail mifepristone to patients to access abortion care safely in their homes.

78% of patients who have obtained medication abortion via telehealth have been very satisfied with their experience.

SOURCE: KFF Analysis of State Policies, October 2021; "Medication Abortion and Telemedicine: Innovations and Barriers During the COVID-19 Emergency

" KFF, June 2021. 

19 States Ban the Use of Telehealth for Abortion or Require a Doctor to be Present When Dispensing the Medication

No ban on telemedicine for abortion

Physical presence of prescribing clinician required

Ban on the use of telehealth for abortion

Thank you.